Anaesthesia and Intensive Care最新文献

{"title":"Cost-effectiveness of Monitored Anaesthesia Care in the Cardiac Catheterisation Laboratory: A response to Meyerson et al.","authors":"Symret K Singh, Sophie A Meyerson, Ben L Olesnicky","doi":"10.1177/0310057X251342256","DOIUrl":"10.1177/0310057X251342256","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"350-352"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"James Young Simpson's <i>Notice of a New Anaesthetic Agent</i>: The first pamphlet on chloroform.","authors":"Rajesh P Haridas","doi":"10.1177/0310057X241285167","DOIUrl":"10.1177/0310057X241285167","url":null,"abstract":"<p><p>James Young Simpson's <i>Notice of a New Anaesthetic Agent</i> is a rare pamphlet of which three copies have hitherto been documented. Two of the three known copies were inscribed by Simpson with the words 'proof copy'. A fourth copy of the pamphlet, also inscribed with the words 'proof copy', has been identified. Although regarded by Simpson as a proof copy, there is previously unreported evidence that the pamphlet was advertised by the publisher on 12 November 1847, published on 13 November 1847, and sold on that day by booksellers in Edinburgh. Thus, the <i>Notice</i> pamphlet was the first published report of the use of chloroform as an anaesthetic agent. The pamphlet was issued 2 or 3 days before the well-known revised edition bearing the title <i>Account of a New Anaesthetic Agent</i>, and one week before the publication of Simpson's papers on chloroform in <i>The Lancet</i> and the <i>Medical Times</i>.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"17-26"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antifibrinolytics-aprotinin in cardiac surgery.","authors":"Christine M Ball, Peter J Featherstone","doi":"10.1177/0310057X251357416","DOIUrl":"10.1177/0310057X251357416","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"292-294"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of induced hypertension for delayed cerebral ischaemia secondary to aneurysmal subarachnoid haemorrhage.","authors":"Timothy P Webber, Benjamin J Young, Marianne J Chapman, Mark E Finnis","doi":"10.1177/0310057X251330315","DOIUrl":"10.1177/0310057X251330315","url":null,"abstract":"<p><p>The study objective was to determine the incidence of complications from induced hypertension used to treat delayed cerebral ischaemia (DCI) complicating aneurysmal subarachnoid haemorrhage (aSAH). Induced hypertension (IH) was defined as the use of vasopressors to achieve a supraphysiological systolic blood pressure target. A single-centre retrospective, observational cohort study was undertaken at the Royal Adelaide Hospital intensive care unit. Data are presented as predominantly median (interquartile range (IQR)). All patients admitted with a diagnosis of aSAH between 1 April 2020 and 1 April 2022 were included and analysed according to whether they did or did not receive vasopressors for IH. A total of 109 patients were included, of which 29 (27%) received vasopressors for IH (median age 58 (IQR 52-65) years, 65% female) and 80 did not receive IH (median age 55 (IQR 49-71) years, 62% female). Clinical DCI or radiological evidence of vasospasm were present in all patients given IH and in 16% of non-IH patients. Patients in the IH group had more ischaemic electrocardiogram (ECG) changes (17.2% <i>vs</i> 2.5%, <i>P</i> = 0.01), urine output (4807 (IQR 3186-5720) ml/day <i>vs</i> 2125 (IQR 1650-2760) ml/day, <i>P</i> < 0.001), fluid administration (4895 (IQR 3555-5999) ml/day <i>vs</i> 2704 (IQR 2300-3403) ml/day, <i>P</i> < 0.001) and intravenous potassium replacement (13 (IQR 5-24) mmol/day <i>vs</i> 5 (IQR 0-13) mmol/day, <i>P</i> = 0.001) than those in the non-IH group. IH was also associated with a greater incidence of hyponatraemia (58% <i>vs</i> 34%, <i>P</i> = 0.02). IH was not associated with arrhythmias or rebleeding. Mortality rates were 17% <i>vs</i> 20% (<i>P</i> > 0.9) in the IH and non-IH groups respectively. In conclusion, IH for the treatment of DCI following aSAH was associated with an increased rate of ischaemic ECG changes, increased urine output and hyponatraemia. However, in the IH group there was no increased rate of rebleeding, and 48% of the IH patients had an improvement in their neurological function following commencement of treatment.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"315-323"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of nitrous oxide usage and knowledge of its environmental effects across healthcare worker groups.","authors":"Emily R Balmaks, Richard Seglenieks, Tanita Botha, Forbes McGain","doi":"10.1177/0310057X251330318","DOIUrl":"10.1177/0310057X251330318","url":null,"abstract":"<p><p>Nitrous oxide (N₂O) is a greenhouse gas that is a significant contributor to the carbon dioxide-equivalent emissions of health services. We aimed to obtain information about N₂O usage and knowledge of its environmental effects among clinical staff at an Australian metropolitan public health network. We distributed an anonymised survey to doctors, nurses and midwives working in anaesthesia, birthing, adult and paediatric emergency medicine, and paediatrics. We analysed 403 of 1320 (31%) responses; 117 of 198 (59%) from anaesthesia, 102 of 368 (27%) from birthing, 137 of 643 (21%) from adult and paediatric emergency medicine and 40 of 111 (36%) from paediatrics. Descriptive statistics were used, and statistical analyses performed on questions regarding environmental knowledge. Of those who currently used N₂O, the majority indicated there were alternative therapies (184/239, 77%), which they would (137/239, 57%) or could (90/239, 38%) be willing to use. Approximately half (219/385, 57%) of respondents correctly identified N₂O as a greenhouse gas, but only 70/382 (18%) identified its global warming potential as hundreds of times that of carbon dioxide. Almost half (180/383, 47%) answered that N₂O is ozone depleting. For anaesthetists, 96% (45/47) knew that N₂O was a greenhouse gas, compared with 41% (32/79) of midwives. This survey demonstrated that frequency of use and reason for use of N₂O varies between clinical groups, and that a significant proportion of staff that use N₂O do not know its harmful environmental characteristics. Our results provide data to inform future research on interventions to minimise clinical use of N₂O, and suggest that educational programs should form part of these efforts.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"332-340"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comment on: Evaluation of opioid prescribing for surgical patients discharged from three metropolitan hospitals between 2012 and 2020.","authors":"Jeremy D Szmerling, Paul Wembridge, Annie Williams, Gordon Mar","doi":"10.1177/0310057X251351649","DOIUrl":"https://doi.org/10.1177/0310057X251351649","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251351649"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective analysis of patients eligible for organ donation in adult intensive care units in Aotearoa New Zealand.","authors":"Lydia Shim, Cynthia J Wensley, Rachael L Parke","doi":"10.1177/0310057X251357317","DOIUrl":"10.1177/0310057X251357317","url":null,"abstract":"<p><p>To analyse characteristics of patients eligible for organ donation in New Zealand (NZ) Intensive Care Units (ICUs) and identify potentially modifiable factors that may benefit donation conversations and their outcomes. Design: A retrospective analysis of eligible patient data collected by Organ Donation New Zealand (ODNZ). Twenty-three adult ICUs in NZ from January 1, 2018, to December 31, 2021. Participants: Adult ICU patients eligible for organ donation via neurological determination of death (DNDD) or circulatory determination of death (DCDD). Patient and ICU characteristics, preparations for donation conversations, donation decisions, and reasons for non-approaches or declines were analysed. Descriptive statistics and binary logistic regression evaluated factors and outcomes. A total of 1,267 cases were analysed (DNDD = 687, DCDD = 580). Donation conversations occurred in 46.9% of cases, with 51.3% resulting in consent. Patients' demographics and admission trends were similar to international reports. Male gender (p = 0.016) and ICU length of stay (p = 0.003) were associated with increased DCDD consent likelihood. Conditions such as encephalopathy (p = 0.012), and cardiovascular disease (p < 0.001) were associated with reduced donation conversation likelihood. Families of Māori patients were associated with reduced donation conversation likelihood (p = 0.002) and families of Māori (p < 0.001), Pasifika (p < 0.001), and Asian patients (p = 0.004) were associated with reduced consent likelihood. Early consultation with ODNZ and timely brain death confirmation positively impacted donation conversations and consent rates. Although not always practised, early ODNZ consultation and timely brain death confirmation were modifiable factors positively associated with conversations being approached and consent. Research exploring ICU staff and families' perspectives may improve understanding of influencing factors.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251357317"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Evaluation of opioid prescribing for surgical patients discharged from three metropolitan hospitals between 2012 and 2020.","authors":"Tristaan W Haddad, Amir L Butt, Kailee N May, Aimee Pak","doi":"10.1177/0310057X251348503","DOIUrl":"https://doi.org/10.1177/0310057X251348503","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251348503"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing plastic in single-use central line insertion packs: A mixed methods observational study.","authors":"Alexandra R Seville, Luise Kazda, Scott McAlister, Kristen M Pickles, Katy Jl Bell","doi":"10.1177/0310057X251358276","DOIUrl":"https://doi.org/10.1177/0310057X251358276","url":null,"abstract":"<p><p>Central venous catheter (CVC) line insertion packs contain single-use plastic and metal items that are disposed of after the pack is opened, regardless of whether the item was used. This study aimed to collect data on the experiences and views of Australian clinicians who use CVC line insertion packs in paediatric critical care, elicit possible solutions to reduce waste associated with these packs, and to estimate the potential for financial and carbon footprint savings from a refined pack. This study was performed in two large paediatric tertiary referral hospitals in Sydney, Australia. Clinicians were invited to a survey and an interview to determine if and what items from a CVC line insertion pack could be excluded. Outcome measures included financial costs and embodied carbon emissions (CO_2e). Of approximately 200 eligible clinicians who were invited, 25 (12.5%) completed the survey and 18 (9%) were interviewed (five did both). All survey respondents were willing to use a new pack that had less waste. They identified five items within the existing CVC pack as commonly non-essential. Interview data identified additional strategies for waste minimisation, including use of a trolley that allowed choice of items to use. Many clinicians expressed moral distress concerning healthcare's impact on the environment. We calculated that a refined CVC pack without these five items would save the two participating hospitals approximately A$1400 and 230 kg CO_2e per year. Financial and carbon savings may be achieved through removing items that are infrequently used and/or through use of a trolley.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251358276"},"PeriodicalIF":1.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A perioperative audit of smoking, smoking cessation advice and pharmacological management of nicotine dependence: Are guidelines enough?","authors":"Boris Waldman, Justin W Payne, Tara S Lawson, Thomas C Lang, Natalie A Smith","doi":"10.1177/0310057X251345506","DOIUrl":"https://doi.org/10.1177/0310057X251345506","url":null,"abstract":"<p><p>Smoking increases anaesthetic and surgical complications. The perioperative period provides an opportunity to give advice and initiate ongoing support to patients who smoke. Our aims were to determine perioperative smoking patterns and how well patients were supported to reduce smoking as well as compliance with the Australian and New Zealand College of Anaesthetists guidelines on smoking. We surveyed all adults having non-emergency surgery at Wollongong Hospital over an 8-week period in 2021. For those who smoked, we analysed their medical record for identification of smoking status and smoking cessation pharmacotherapy prescription. Sixteen per cent of patients (<i>n</i> = 111) had smoked in the 30 days before surgery. Of that group, 83% did not think that smoking might cause a problem with their surgery or anaesthetic, and 46% did not report receiving advice to stop smoking. When advice to stop smoking was given, it was associated with an attempt to quit, especially when given by a surgeon. Attendance at the preadmission clinic was associated with the provision of smoking cessation advice but not a quit attempt. Nicotine replacement therapy was used by 11% prior to surgery, and only 7% immediately post-surgery. Our findings show low rates of perioperative smoking cessation advice and nicotine replacement therapy prescription, similar to those reported by other studies over the past two decades in Australia. It provides further evidence that the Australian and New Zealand College of Anaesthetists and other society guidelines alone have not led to major improvements in our management of perioperative smoking, and that hospital-specific routine interventions are needed.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251345506"},"PeriodicalIF":1.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}